What is the Affordable Care Act (ACA)?

An increasingly popular way of paying for drug and alcohol rehab, the Patient Protection and Affordable Care Act (ACA) is a health care system law passed in 2010 that covers addiction treatment. If you are addicted to drugs and alcohol, the ACA may be a way to help pay for it.

Under the ACA, addiction is no longer considered a pre-existing condition for insurance purposes.

The ACA sponsors insurance plans for sale on an online platform called the Health Insurance Marketplace. These medical insurance plans offer addiction treatment coverage similar to private insurance plans.

Need-based tax credits make many ACA plans less expensive for consumers.

The ACA also expands funds and treatment options available to Americans covered by Medicare and Medicaid. The costs and requirements for Medicare and Medicaid coverage are different from Marketplace medical insurance plans.

Some states run their own Health Insurance Marketplace platforms separate from Healthcare.gov. Differences between state and federal medical plans are based on Medicare and Medicaid coverage in each state.

Percentage of Addiction Expenses Covered by Obamacare

Anyone shopping for medical insurance can purchase an ACA-sponsored health plan. The five types of Health Insurance Marketplace plans available include:

Bronze plans – 60 percent expense coverage

Silver plans – 70 percent expense coverage

Gold plans – 80 percent expense coverage

Platinum plans – 90 percent expense coverage

Catastrophic — 60 percent total average cost coverage

*Available only to those under 30 years old or those with extending circumstances

See how Jerryovercame hisaddiction.

Who is Eligible for Coverage?

Americans with incomes between the federal poverty level (FPL) and four times the federal poverty level are eligible for ACA tax credits. The FPL changes according to family size. These statistics from the Medicaid government website outline federal poverty levels in 2015:

ACA Income Eligibility

Family Size

Max. Annual Income

1

$11,770

2

$15,930

3

$20,090

4

$24,250

“Cost-sharing” support is available to Silver Plan holders living below 2.5 times the poverty level. For example, a single person making $29,425 a year or less would be eligible; a two-income household would need to make $39,825 or less. These cost-sharing measures reduce deductibles, co-payments, insurance premiums and other out-of-pocket expenses for those consumers.

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How Does the Affordable Care Act Broaden Treatment?

The ACA reduces addiction treatment costs, increases treatment options and extends many benefits of employer-provided insurance plans to individual medical insurance plans. The ACA also allows young adults 26 and younger to remain on their parents’ health care plan.

These expanded benefits include addiction treatment despite “pre-existing health conditions.” ACA funding opens hundreds of new inpatient and outpatient health centers every year to support this increased care. Many of these new centers also cover treatment for co-occurring mental health conditions like depression.

Affordable Care Act Statistics

11.7

million

Nearly 12 million Americans have enrolled in Health Insurance Marketplace plans since February 2015.

Who Accepts Affordable Care Act Plans?

If you don’t already have an ACA-sponsored plan, you can apply for one online during the open registration periods. You can find a registration schedule or request a special registration form at Healthcare.gov if you miss the normal registration window.

An addicted person can purchase one of these medical insurance plans by completing the following steps:

Logging on to the Website

Visit the Health Insurance Marketplace at Healthcare.gov to begin the process.

Creating an Account

Create a Health Insurance Marketplace online account.

Completing Your Application

Fill out the Marketplace application and see available health plans.

Once approved for an ACA-sponsored plan, speak with a Health Insurance Marketplace attendant to determine which health insurance package is right for you and your family. Whether you plan to enter an inpatient or outpatient program is one of many factors to consider when purchasing an ACA coverage plan.

Questions about treatment?

Finding a Rehab Center

Addiction recovery can be a long, difficult process. Settling on the right rehab program is crucial to getting — and staying — sober. Not every program offers the same treatment options or accepts every insurance plan. Our treatment specialists can help you determine which treatment centers accept your insurance.

AddictionCenter.com is a referral service that provides information about addiction treatment practitioners and facilities. AddictionCenter.com is not a medical provider or treatment facility and does not provide medical advice. AddictionCenter.com does not endorse any treatment facility or guarantee the quality of care provided, or the results to be achieved, by any treatment facility. The information provided by AddictionCenter.com is not a substitute for professional treatment advice.